The risk of having a heart attack or stroke increases with factors such as raised cholesterol, raised blood pressure, increased weight, smoking and taking little exercise, but the risk becomes less related to these factors with increasing age. Newer lab tests that are are linked to heart attacks, including homocysteine which is an amino acid present in blood, have recently been shown to add very little to the calculation of risk in people aged up to about 80.Research workers from Leiden University in the Netherlands have carried out a small study of risk factors in very old people. Their subjects were 302 residents of Leiden who were 85 at the start of the five year study and who had no history of heart disease. They found that at this age conventional risk assessment no longer accurately predicted death. In contrast, plasma homocysteine on its own identified those at high risk of dying from heart attack or stroke. The authors suggest that their findings warrant checking in further groups of the very old because, if confirmed, homocysteine alone could be used to select old people for preventive treatment.

The U.S. Preventive Services Task Force (USPSTF) recently updated its 2008 guidelines on cholesterol-lowering medications known as statins. The recommendations were released in the November 15th issue of the Journal of the American Medical Association.

A large trial of screening pregnant women for Group B Streptococcus in late pregnancy or in labour will study its effect in reducing life-threatening infection in the newborn.

On 7 August 2013 the National Institute for Health and Care Excellence (NICE) approved the use of a molecular test for use during breast cancer surgery. The technique allows the surgeon to find out whether cancer cells have spread to lymph nodes in the armpit. They are then able to decide whether all the lymph nodes within the armpit should be removed during the same operation, rather than having to wait 5 to 15 days for the results of examination of tissue under a microscope in the laboratory. Early detection of spread can avoid a second operation and allow the early start of treatments such as chemotherapy.